Ahip 2025 final Final Exams With Complete Solutions
Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern? - ANSWER-Medigap plans help
beneficiaries cover Original Medicare benefits, but they coordinate with
Original Medicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original
Medicare Part A and Part B. She would also like to enroll in a Medicare
Supplement (Medigap) plan. Anita's older neighbor Mel has told her about
the Medigap Plan F in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita
comes to you for advice. What should you tell her? - ANSWER-You are sorry to
disappoint Anita, but a Medigap F plan is no longer available to those who
turn age 65 after January 1, 2020. Anita might instead consider other
Medigap plans that offer foreign travel benefits but do not cover the Part B
deductible.
What impact, if any, have recent regulatory changes had on Medigap plans? -
ANSWER-b.
The Part B deductible is no longer covered for individuals newly eligible for
Medicare starting January 1, 2020.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay that
Medicare will cover? - ANSWER-Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
and is being successfully treated for that condition. However, she and her
physicians feel that after her lengthy hospital stay, she will need a month or
two of nursing and rehabilitative care. What should you tell them about
Original Medicare's coverage of care in a skilled nursing facility? - ANSWER-
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - ANSWER-Medicare does not cover massage therapy, or, in
general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and
now she wants to enroll in a PPO that does not include drug coverage. What
should you tell her about obtaining drug coverage? - ANSWER-She can enroll
in the PPO, but she will not be able to purchase a stand-alone Medicare Part
D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - ANSWER-Mrs. Radford must
be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery
and expected that he would have certain services and items covered by the
plan with minimal out-of-pocket costs because his MA-PD coverage has been
very good. However, when he received the bill, he was surprised to see large
charges in excess of his maximum out-of-pocket limit that included some
services and items he thought would be fully covered. He called you to ask
what he could do? What could you tell him? - ANSWER-You can offer to review
the plans appeal process to help him ask the plan to review the coverage
decision.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled
in Part B because he has coverage through an employer plan. If he wants to
enroll in a Medicare Advantage plan, what will he have to do? - ANSWER-He
will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts
the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan
for treatment. How much may Dr. Brennan charge? - ANSWER-
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that
does not include drug coverage. She wants to enroll in the plan and enroll in
a stand-alone prescription drug plan. What should you tell her? - ANSWER-
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug
plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - ANSWER-You would need to ask Mr. Kelly if he is enrolled in Part A
and Part B and if he lives in the PFFS plan's service area.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of maintaining
control over a Medical Savings Account (MSA), but is not sure if the plan
Mrs. Paterson is concerned about the deductibles and co-payments
associated with Original Medicare. What can you tell her about Medigap as
an option to address this concern? - ANSWER-Medigap plans help
beneficiaries cover Original Medicare benefits, but they coordinate with
Original Medicare coverage.
Anita Magri will turn age 65 in August 2023. Anita intends to enroll in Original
Medicare Part A and Part B. She would also like to enroll in a Medicare
Supplement (Medigap) plan. Anita's older neighbor Mel has told her about
the Medigap Plan F in which he is enrolled. It not only provides foreign travel
emergency benefits but also covers his Medicare Part B deductible. Anita
comes to you for advice. What should you tell her? - ANSWER-You are sorry to
disappoint Anita, but a Medigap F plan is no longer available to those who
turn age 65 after January 1, 2020. Anita might instead consider other
Medigap plans that offer foreign travel benefits but do not cover the Part B
deductible.
What impact, if any, have recent regulatory changes had on Medigap plans? -
ANSWER-b.
The Part B deductible is no longer covered for individuals newly eligible for
Medicare starting January 1, 2020.
Mr. Rainey is experiencing paranoid delusions and his physician feels that he
should be hospitalized. What should you tell Mr. Rainey (or his
representative) about the length of an inpatient psychiatric hospital stay that
Medicare will cover? - ANSWER-Medicare will cover a total of 190 days of
inpatient psychiatric care during Mr. Rainey's entire lifetime.
Mrs. Shields is covered by Original Medicare. She sustained a hip fracture
and is being successfully treated for that condition. However, she and her
physicians feel that after her lengthy hospital stay, she will need a month or
two of nursing and rehabilitative care. What should you tell them about
Original Medicare's coverage of care in a skilled nursing facility? - ANSWER-
Mrs. West wears glasses and dentures and has enjoyed considerable pain
relief from arthritis through massage therapy. She is concerned about
whether or not Medicare will cover these items and services. What should
you tell her? - ANSWER-Medicare does not cover massage therapy, or, in
general, glasses or dentures.
, Ms. Gibson recently lost her employer group health and drug coverage and
now she wants to enroll in a PPO that does not include drug coverage. What
should you tell her about obtaining drug coverage? - ANSWER-She can enroll
in the PPO, but she will not be able to purchase a stand-alone Medicare Part
D prescription drug plan.
Mrs. Radford asks whether there are any special eligibility requirements for
Medicare Advantage. What should you tell her? - ANSWER-Mrs. Radford must
be entitled to Part A and enrolled in Part B to enroll in Medicare Advantage.
Mr. Barker enjoys a comfortable retirement income. He recently had surgery
and expected that he would have certain services and items covered by the
plan with minimal out-of-pocket costs because his MA-PD coverage has been
very good. However, when he received the bill, he was surprised to see large
charges in excess of his maximum out-of-pocket limit that included some
services and items he thought would be fully covered. He called you to ask
what he could do? What could you tell him? - ANSWER-You can offer to review
the plans appeal process to help him ask the plan to review the coverage
decision.
Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled
in Part B because he has coverage through an employer plan. If he wants to
enroll in a Medicare Advantage plan, what will he have to do? - ANSWER-He
will have to enroll in Part B.
Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts
the plan's terms and conditions for payment. Mary Rodgers sees Dr. Brennan
for treatment. How much may Dr. Brennan charge? - ANSWER-
Mrs. Chou likes a Private Fee-for-Service (PFFS) plan available in her area that
does not include drug coverage. She wants to enroll in the plan and enroll in
a stand-alone prescription drug plan. What should you tell her? - ANSWER-
She could enroll in a PFFS plan and a stand-alone Medicare prescription drug
plan.
Mr. Kelly wants to know whether he is eligible to sign up for a Private fee-for-
service (PFFS) plan. What questions would you need to ask to determine his
eligibility? - ANSWER-You would need to ask Mr. Kelly if he is enrolled in Part A
and Part B and if he lives in the PFFS plan's service area.
Mrs. Lyons is in good health, uses a single prescription, and lives
independently in her own home. She is attracted by the idea of maintaining
control over a Medical Savings Account (MSA), but is not sure if the plan
